Transient, Image-Guided Gel-Dissection for Percutaneous Thermal Ablation

被引:1
作者
Liu, Kathy [1 ]
Russo, Mario [2 ,3 ]
Ellis, Joshua S. [3 ]
Capua, John Di [3 ]
Wu, Dufan [2 ,4 ]
Smolinski-Zhao, Sara [3 ]
Kalva, Sanjeeva [3 ]
Arellano, Ronald S. [3 ]
Irani, Zubin [3 ]
Uppot, Raul [3 ]
Linderman, Stephen W. [5 ,6 ]
Gupta, Rajiv [2 ,4 ]
Aizenberg, Joanna [1 ,7 ]
Srinivasan, Shriya [1 ]
Som, Avik [3 ,4 ]
机构
[1] Harvard John A Paulson Sch Engn & Appl Sci, Mat Sci & Mech Engn, Cambridge, MA 02138 USA
[2] Harvard Med Sch, 25 Shattuck St, Boston, MA 02115 USA
[3] Massachusetts Gen Hosp, Dept Radiol, Div Intervent Radiol, Boston, MA 02114 USA
[4] Massachusetts Gen Hosp, Dept Radiol, Div Neuroradiol, Boston, MA 02114 USA
[5] MIT, David H Koch Inst Integrat Canc Res, Cambridge, MA 02139 USA
[6] Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02115 USA
[7] Harvard Univ, Dept Chem & Chem Biol, Cambridge, MA 02138 USA
基金
美国国家科学基金会;
关键词
ablations; degradable; hydrodissection; hydrogels; injectable; percutaneous; RADIOFREQUENCY ABLATION; HEPATOCELLULAR-CARCINOMA; MICROWAVE ABLATION; TUMOR ABLATION; GUM; HYDRODISSECTION; INJECTION; HYDROGELS; LIVER; REGENERATION;
D O I
10.1002/adhm.202400272
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Image-guided tumor ablative therapies are mainstay cancer treatment options but often require intra-procedural protective tissue displacement to reduce the risk of collateral damage to neighboring organs. Standard of care strategies, such as hydrodissection (fluidic injection), are limited by rapid diffusion of fluid and poor retention time, risking injury to adjacent organs, increasing cancer recurrence rates from incomplete tumor ablations, and limiting patient qualification. Herein, a "gel-dissection" technique is developed, leveraging injectable hydrogels for longer-lasting, shapeable, and transient tissue separation to empower clinicans with improved ablation operation windows and greater control. A rheological model is designed to understand and tune gel-dissection parameters. In swine models, gel-dissection achieves 24 times longer-lasting tissue separation dynamics compared to saline, with 40% less injected volume. Gel-dissection achieves anti-dependent dissection between free-floating organs in the peritoneal cavity and clinically significant thermal protection, with the potential to expand minimally invasive therapeutic techniques, especially across locoregional therapies including radiation, cryoablation, endoscopy, and surgery. Thermal ablation is a key therapeutic option for treating cancers but risks collaterally damaging adjacent organs from a lack of protective technologies. "Gel-dissection," an injectable hydrogel ablation protection technique to enable long-lasting, triggerably degradable protection both between and within tissues for ablation protection is developed. A model to expand gel-dissection to other anatomical regions and medical procedures is also presented. image
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页数:10
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